CAR-T shows ‘superior outcomes’ in adults with post-transplant relapsed leukemia
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Key takeaways:
- CAR-T conferred superior survival outcomes among patients with B-cell ALL relapse after HSCT.
- Results showed markedly longer time to CAR-T treatment compared with alternative therapies.
Patients with post-transplant relapsed B-cell acute lymphoblastic leukemia who received chimeric antigen receptor T-cell therapy had superior outcomes compared with alternative approaches, study results showed.
Findings presented at European Society for Blood and Marrow Transplantation-European Hematology Association 6th European CAR T-cell Meeting revealed significantly longer PFS and OS outcomes for individuals who received CAR-T after post-transplant relapse.
“In the context of numerous innovative targeted therapies for B-ALL, CAR-Ts have now, for the first time, exhibited superior outcomes over alternative approaches in post-transplant relapsed B-[cell] ALL,” Alex Rampotas, MD, clinical research training fellow at University College London, and colleagues wrote.
Background and methodology
Survival outcomes have historically been poor among adults who relapse after allogeneic hematopoietic stem cell transplantation for B-cell ALL; however, CAR-T has the potential to improve treatment of such patients.
Because studies have not compared CAR-T to other novel B-cell ALL therapies, researchers assessed the real-world efficacy and outcomes of such treatments among patients with B-cell ALL after allogeneic HSCT at six major transplant centers in the United Kingdom.
The retrospective study included 123 patients, 93 of whom had evaluable data for analysis (median follow-up, 24.8 months).
Of the 93 evaluable patients, 17 received CAR-T and 75 received non-CAR-T therapies, including tyrosine kinase inhibitors, palliative/supportive regimens, inotuzumab (Besponsa, Pfizer), blinatumomab (Blincyto, Amgen), intensive chemotherapy and allogeneic HSCT.
Researchers noted younger patients with higher-risk disease received CAR-T.
Results, next steps
The analysis showed a median time from relapse to treatment of 2.8 months among patients receiving CAR-T and 0.32 months among those receiving non-CAR-T therapies. Patients treated with CAR-T also had significant survival advantages in median OS (31 vs. 6.4 months) and PFS (16.7 vs. 3.7 months).
“The clear superior PFS and OS should encourage the use of more CAR T-cell therapies for this challenging cohort, while further improvements are imperative to enhance outcomes,” Rampotas and colleagues wrote.
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Rampotas A, et al. Real-world efficacy of CAR-T cells in the era of novel treatments for post transplant adult relapsed B-acute lymphoblastic leukemia. Presented at: European Society for Blood and Marrow Transplantation-European Hematology Association 6th European CAR T-cell Meeting; Feb. 15-17, 2024; Valencia, Spain.
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